Massage therapy is widely used throughout the world and has been shown to have a variety of positive effects on well being, particularly the ability to reduce anxiety, improve mood, and lower blood pressure. Its positive effects on mood and anxiety indicate that the brain is a target organ for massage. In this regard, massage-induced changes in electroencephalogram (EEG) patterns have been observed. Massage could be a non-pharmacologic method of making specific changes in human central nervous system (CNS) neurochemistry. However, the effects of massage on CNS neurohormone and neurotransmitter concentrations are unknown. The goal of this exploratory/developmental project (R21) is to identify specific massage-induced changes in cerebrospinal fluid (CSF) neurochemical concentrations and dynamics in persons with low-grade symptoms of both anxiety and depression. We postulate that a 40-minute massage will acutely change CSF neurochemistry and, secondarily, that the anti-anxiety, mood-elevating, and blood pressure-lowering effects of massage will be demonstrated during our continuous CSF sampling paradigm. We will continuously obtain small quantities of spinal canal CSF for 6 hours from a thin, flexible, indwelling catheter before, during, and after volunteers with anxiety and depressive symptoms undergo either a 40-min massage while listening to soft white noise or while only listening to soft white noise for 40 minutes. All social interactions will be strictly controlled and matched. Subjective mood and anxiety will be serially assessed by visual analog scales;blood pressure and heart rate will be monitored using automated instruments. Several hormones and neurotransmitters known or hypothesized to mediate anxious and depressed symptoms will be measured in 37 CSF samples per volunteer, obtained at 10-minute intervals. We expect this work to demonstrate the feasibility of obtaining acute anti-anxiety, antidepressant, and physiological relaxation responses to massage during CSF sampling. Moreover, we expect to identify one or several massage-responsive CSF neurochemicals worthy of further study, along with estimates of effect sizes that will be used to power a subsequent R01-level investigation. This project will yield the first information on the acute CNS neuroendocrine effects of massage in the human. Project Narrative: The aim of this project is to identify the central nervous system neurochemical effects of a single massage in people with low-grade depressive and anxiety symptoms. A variety of neurotransmitters and hormones in cerebrospinal fluid will be screened using a strictly controlled trial of 40 minute massage plus relaxing white noise versus 40 minutes of relaxing white noise alone. This research opens a new line of investigation into the central nervous system neurochemical mechanisms of massage;once its neuroendocrine effects are known, massage could be used as a non-pharmacologic method of changing brain neurochemistry in specific ways.